• Registered Nurses Association of Ontario (RNAO). Client centered care supplement. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2006 Mar. 8 p. [38 references]



• Registered Nurses Association of Ontario (RNAO). Client centred care. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2002 Jul. 70 p. [63 references]

This is the current release of the guideline.

Note from the National Guideline Clearinghouse (NGC): In March 2006, the Registered Nurses Association of Ontario (RNAO) amended the current practice recommendations for this topic. Through the review process, one recommendation was deleted and others were reworded to reflect new knowledge. The recommendations are noted below as "changed" or "unchanged."

Practice Recommendation

Recommendation 1 (Changed March 2006)

Nurses embrace the following values and beliefs: respect; human dignity; clients are experts for their own lives; clients as leaders; clients' goals coordinate care of the healthcare team; continuity and consistency of care and caregiver; timeliness; responsiveness and universal access to care. These values and beliefs must be incorporated into, and demonstrated throughout, every aspect of client care and services.

Education Recommendations

Recommendation 2

Recommendation has been deleted and incorporated as a bullet under recommendation 5.

Recommendation 3 (Unchanged)

The principles of client centred care should be included in the basic education of nurses in their core curriculum, be available as continuing education, be provided in orientation programs and be sustained through professional development opportunities in the organization. Organizations should engage all members of the healthcare team in this ongoing education process.

Organization and Policy Recommendations

Recommendation 4 (Unchanged)

To foster client centred care consistently throughout an organization, healthcare services must be organized and administered in ways that ensure that all caregivers, regardless of their personal attributes, enact this practice successfully. This includes opportunities to gain the necessary knowledge and skills to really engage with clients from their standpoint, as well as organizational models of care delivery that allow nurses and clients to develop continuous, uninterrupted, and meaningful relationships.

Recommendation 5 (Changed March 2006)

Nursing best practice guidelines can be successfully implemented only where there are adequate planning, resources, organizational and administrative support, as well as appropriate facilitation. Organizations may wish to develop a plan for implementation that includes:

• Board and senior management understanding and support
• An assessment of organizational readiness and barriers to education
• Community involvement (whether in a direct or indirect supportive function) who will contribute to the implementation process
• Ongoing opportunities for discussion and education to reinforce the importance of best practices
• Opportunities for reflection on personal and organizational experience in implementing guidelines
• Initial and sustained financial support
• Members of the public

In this regard, RNAO (through a panel of nurses, researchers and administrators) has developed the "Toolkit: Implementation of Clinical Practice Guidelines", based on available evidence, theoretical perspectives and consensus. The Toolkit is recommended for guiding the implementation of the RNAO nursing best practice guideline on Client Centred Care.

None provided

Recommendations were based on the evaluation of evidence from a systematic review, other quantitative studies, nursing theories, qualitative sources and client reports of their experiences. Expert consensus was utilized when scientifically formalized knowledge was not available.

• Registered Nurses Association of Ontario (RNAO). Client centered care supplement. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2006 Mar. 8 p. [38 references]



• Registered Nurses Association of Ontario (RNAO). Client centred care. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2002 Jul. 70 p. [63 references]

Not applicable: The guideline was not adapted from another source.

2002 Jul (addendum released 2006 Mar)

Registered Nurses Association of Ontario - Professional Association

Funding was provided by the Ontario Ministry of Health and Long Term Care.

Not stated

Revision Panel Members

Penny Nelligan, RN, BScN, MSN
Team Leader
Executive Director
Huron County Health
Clinton, Ontario

Frances Flint, RN, MN
Director Nursing Practice
Sunnybrook & Women's College Health
Sciences Centre
Toronto, Ontario

Doris Grinspun, RN, MSN, PhD(c) O.Ont
Executive Director
Registered Nurses' Association of Ontario
Toronto, Ontario

Nancy Lefebre, RN, MScN
Chief Clinical Executive, Vice President
Knowledge & Practice
Saint Elizabeth Healthcare
Markham, Ontario

Sheila Lewis, BScN, MHSc
Associate Lecturer
School of Nursing
York University
Toronto, Ontario

Dianne Martin, RPN, RN, BScN
Senior Policy Analyst
Nursing Secretariat
Ministry of Health and Long-Term Care
Toronto, Ontario

Suzanne Payeur-Grenier, RN
Clinical Manager
Niagara Health Systems
Welland, Ontario

Elizabeth Peter, RN, PhD
Associate Professor
Faculty of Nursing
University of Toronto
Toronto, Ontario

Beryl Pilkington, RN, PhD
Associate Professor
School of Nursing
York University
Toronto, Ontario

Kari Van Camp, RN, MScN. CPMHN(C), CARN-AP
Advanced Practice Nurse
West Park Healthcare Centre
Toronto, Ontario

Barb Van Maris, BSc, MSc
Vice President
NRC+Picker Canada
Markham, Ontario

Tracey Skov, RN, BScN, MSN(c)
Program Coordinator
Nursing Best Practice Guidelines Program
Registered Nurses' Association of Ontario
Toronto, Ontario

The Registered Nurses Association of Ontario (RNAO) received funding from the Ministry of Health and Long-Term Care (MOHLTC). This guideline was developed by a panel of nurses and researchers convened by the RNAO and conducting its work independent of any bias or influence from the MOHLTC.

This is the current release of the guideline.

This NGC summary was completed by ECRI on December 17, 2003. The information was verified by the guideline developer on January 16, 2004. This NGC summary was updated by ECRI on June 22, 2006.

With the exception of those portions of this document for which a specific prohibition or limitation against copying appears, the balance of this document may be produced, reproduced, and published in its entirety only, in any form, including in electronic form, for educational or non-commercial purposes, without requiring the consent or permission of the Registered Nurses Association of Ontario, provided that an appropriate credit or citation appears in the copied work as follows:

Registered Nurses' Association of Ontario (2006). Client Centred Care. (rev. suppl.) Toronto, Canada: Registered Nurses' Association of Ontario.